This Is Why Women In England Can’t Take Abortion Pills At Home

Across the United Kingdom (with the exception of Northern Ireland) abortion has been legal since the 1967 Abortion Act came into force. However, many experts argue that it’s still not as accessible as it could be.

When Sarah (not her real name) was 16 she accidentally became pregnant and decided to have an abortion. At the time, she was living in a commuter belt town where South London meets the Surrey Hills. She recalls how her GP referred her to a London clinic for a medical abortion (which involves taking pills as opposed to undergoing a surgical procedure).

READ MORE: Facts About Women Around The World

Now 30, Sarah says she remembers the experience ‘like it just happened’. What has stuck with her, above all, is the fact that she had to travel home after having taken the first pill and was warned that she might bleed or ‘feel unwell’ on the way. ‘I had to take a taxi from the clinic to the station in central London’ she tells The Debrief ‘and then get a 45-minute train back to my home station and then my mum drove me home’.

In total, Sarah’s journey time was around one hour and forty-five minutes. She tells The Debrief that she remembers ‘feeling a bit sick’ and experiencing cramps as she made her way home; ‘mainly I was scared’ she says, ‘I couldn’t stop thinking that I would pass out or bleed everywhere and then everyone would know…’. For Sarah, the logistical rigmarole of having to move around while technically having an abortion was ‘actually much worse’ than having to make the decision terminating an unwanted pregnancy in the first place. ‘I knew it was 100% the right decision’ she reflect ‘but the process made me feel guilty’.

WATCH NOW: The Debrief's Meets The Women Fighting For Abortion Rights In Northern Ireland

In a medical abortion, like the one Sarah had, you take two pills, each of which contains a hormone: mifepristone and misoprostol. Mifepristone works by blocking the hormone progesterone, without this hormone the lining of the uterus breaks down and the pregnancy cannot continue. Misoprostol works by making the womb contract, this causes the cramping, bleeding and, ultimately, loss of pregnancy which is similar to the experience of having a miscarriage.

Stories like Sarah’s are why the British Pregnancy Advisory Service have been calling on the government to change England’s abortion legislation for several years. As things stand, under the current legislation a woman must take the pills (whether you take them together or a few days apart) with the consent of two doctors and inside a hospital or licensed clinic. She is not allowed to do it in her own home. This means that if, like Sarah, you take the pills at the same time you must then return home whilst potentially experiencing side effects. For women who take the pills a few days apart it means they must make two trips to a clinic.

However, last year, the Scottish government changed their legislation and became the first part of the United Kingdom to allow women to take the abortion pill in the comfort of their own homes. This change brought Scotland in line with other European countries such as Sweden and France.

At the time Scotland’s Public Health Minister, Aileen Campbell, said: ‘abortion can be an emotive subject. However, I am proud this government is working hard to ensure women are always able to access clinically safe services’.

This may have paved the way for further movement. Yesterday, following suit, the Welsh government said that women should be allowed to take abortion pills at home. Vaughan Gething, the Welsh Health Secretary, said that his officials are now looking at how legislation can be changed to allow women to undergo abortions at home in Wales.

Responding to the announcement Clare Murphy, the Director of External Affairs at BPAS, said it was ‘brilliant news’. She added that the Welsh government’s plans ‘to enable women to take the second dose of medication for early abortion at home, as is permitted in many countries – including Scotland – and recommended by the World Health Organisation’ means ‘women will no longer have to risk bleeding, cramping and even miscarriage on the way home after taking the pills in the clinic’. Murphy also pointed out that the change will enable women to ‘take the medication at the time that is best for them, when they are in the privacy and comfort of their own surroundings’.

As The Debrief reported last year, the latest Department of Health figures show that medical abortions are the most common form of abortion in England and Wales, accounting for over half of all abortions. However, BPAS has found that some women are resorting to illegally ordering the pills online themselves because of the hurdles they face – including travel and waiting times - to accessing in-clinic care.

With both Wales and Scotland have now fallen in line with the World Health Organisation’s advice, could it only be a matter of time before England is forced to take action too? Murphy told The Debrief ‘the Secretary of State for Health, Jeremy Hunt, also has the power to extend this dignity to women in England. We call on him as a matter of urgency to do the right thing by women and bring forward proposals to enable women to use misoprostol at home for early abortion, as they already can in England for incomplete miscarriage’. She noted that there was no ‘clinical’ reason to prevent women from taking abortion medication at home and that denying them this option was purely ‘political’ because at home medical abortion is ‘a safe, evidence-based measure’ which ‘would improve women’s experience immeasurably at a difficult time’.

It’s worth nothing that Professor Lesley Regan, President of the Royal College of Obstetricians and Gynecologists (RCOG) also backs at home abortions and [has said that it makes no sense that women who want to terminate pregnancies are treated differently from women who need induced miscarriages because a baby has died](https://www.thetimes.co.uk/article/professor-lesley-regan-abortion-pill-safer-at-home-than-in-clinic-mrqw3r00h .).

‘If you were to come to me in the miscarriage clinic and I had to tell you your baby had died, I’d be saying: “here are the tablets, perhaps you want to go home. It is Wednesday, why don’t you do this on Friday, in the comfort of your own home and the weekend, and you can get over it?”’ [she said last year](https://www.thetimes.co.uk/article/professor-lesley-regan-abortion-pill-safer-at-home-than-in-clinic-mrqw3r00h .), ‘but if you come for a termination, I make you take them in front of me.’

Across the United Kingdom and in Ireland a conversation is happening about abortion. In May, Ireland will vote on whether to repeal the Eighth Amendment and allow women to undergo abortions legally in the country for the first time. In the Ilse of Man, there are plans to review Manx abortion law which currently only permits women to terminate a pregnancy if it is the result of rape or there are mental health concerns for the mother.

Scotland and Wales are adding to this nation-wide conversation by demonstrating that while abortion is legal in their countries, it could certainly be better, more compassionate and more comfortable. Meanwhile,abortion remains illegal in Northern Irelandand it seems that the government in Westminster have some catching up to do. Official statistics show that around 180,000 women access abortions each year in England, they deserve the same level of care as women in Scotland and Wales.

A Department of Health and Social Care spokesperson told The Debrief 'around 180,000 women have an abortion each year in England - our priority is always to ensure that care is safe and high quality. We will continue to monitor the evidence surrounding home-use'.

Follow Vicky on Twitter @Victoria_Spratt

This article originally appeared on The Debrief.